Ready, but fighting Aetna

Been fighting Aetna for 2 months to approve my surgery. Very frustrating. They want 6 months controlled w/Dr diet, I don't have that. Any suggestions? My BMI is 60.8,I have lower back pain, to the point of nubness, I can barley walk, my sleep study had me stopping breathing 166 times in a hour. I weigh almost 400 lbs. How can they not see that I need this surgery? Why should I have to get the rest of the co-morbidities before they realize this?

What Dr are you seeing. Dr Keith is the BEST. Make an appt with him. His staff knows how to deal with ins companies.

Dr. Phillip Floyd is also a wonderful doctor. I have a friend that just found out today that she was approved through Aetna and has surgery on Oct 16th. I see where Aetna pays for the surgery all the time, so I'm not sure why you cannot get approved. It would be worth checking into other doctors and continue fighting the insurance company. HTH, just my opinion.

I have Aetna and was originally told the same thing about the MD supervised diet program. I did not have this either. I had recent Weigh****chers records and Broadway Clinic records from 2000. My BMI is 57.3 and I was diagnosed with sleep apnea two years ago. That is my only co-morbitity. Dr. Philip Floyd's employee Frauke Davis wrote an appeal letter on my behalf and got me approved within 2 weeks of the denial letter. I was pleasantly surprised when she called to say I had been approved!

I have tried to e-mail the group that u have listed to no avail. Will you please advise me on how to contact them. this is my info... My info was submitted to Aetna on Monday, on Tuesday Aetna requested a code breakdown on one of my diet doctors sheets. I guess they used codes that no one could read. Well that was faxed the same day. I called Aetna yesterday and still pending, said it was with the board. I am so nurvous, my stomach is turnning. I pray they approve me! My surgeons office would not submitt any paper work without all the papers being there, and becasue I have an HMO, the authorization was submitted by my PCP. I needed to have weight loss history for 5 years. Well I have been going to diet doctors for years, I did not have the year 1999 and 2000 but had a certified letter as to why I did not. The nurse said Aetna accepted the letter. I had the letter from my PCP and the one from my Surgeon, Dr. Johnson. This is the hard part, waiting. I cannot think of any reason why they would deny me coverage. I also had weight documents from the past two years which they requested. Now, I figure if they came back the very next day and requested a code break down, then maybe thats all they need. I sure hope so. Please give me some advise. HELP! im so scared, just this period alone will make someone gain 20lbs. 10/17/03 Well the insurance denied me today! The diet doctor that I have been going to for the past two year, did not note on the chart that we discussed diet and exercise, even though this is his program. They are going to write a letter on Monday to show that even though this is not on his chart, his program is diet and exercise, so the chart was not noted correctly per Aetna! I am so depressed... They say I did not meet the criteria for diet and exercise. I know this was just denied today but I need help on what to do starting Monday.